Abstract
Objectives
(1) To examine differences in patient-reported outcomes, neuropsychological tests,
and thalamic functional connectivity (FC) between patients with mild traumatic brain
injury (mTBI) and individuals without mTBI and (2) to determine longitudinal associations
between changes in these measures.
Design
Prospective observational case-control study.
Setting
Academic medical center.
Participants
A sample (N=24) of 13 patients with mTBI (mean age, 39.3±14.0y; 4 women [31%]) and
11 age- and sex-matched controls without mTBI (mean age, 37.6±13.3y; 4 women [36%]).
Interventions
Not applicable.
Main Outcome Measures
Resting state FC (3T magnetic resonance imaging scanner) was examined between the
thalamus and the default mode network, dorsal attention network, and frontoparietal
control network. Patient-reported outcomes included pain (Brief Pain Inventory), depressive
symptoms (Patient Health Questionnaire-9), posttraumatic stress disorder ([PTSD] Checklist
– Civilian Version), and postconcussive symptoms (Rivermead Post-Concussion Symptoms
Questionnaire). Neuropsychological tests included the Delis-Kaplan Executive Function
System Tower test, Trails B, and Hotel Task. Assessments occurred at 6 weeks and 4
months after hospitalization in patients with mTBI and at a single visit for controls.
Results
Student t tests found increased pain, depressive symptoms, PTSD symptoms, and postconcussive
symptoms; decreased performance on Trails B; increased FC between the thalamus and
the default mode network; and decreased FC between the thalamus and the dorsal attention
network and between the thalamus and the frontoparietal control network in patients
with mTBI as compared with controls. The Spearman correlation coefficient indicated
that increased FC between the thalamus and the dorsal attention network from baseline
to 4 months was associated with decreased pain and postconcussive symptoms (corrected
P<.05).
Conclusions
Findings suggest that alterations in thalamic FC occur after mTBI, and improvements
in pain and postconcussive symptoms are correlated with normalization of thalamic
FC over time.
Keywords
List of abbreviations:
DAN (dorsal attention network), DMN (default mode network), FC (functional connectivity), fMRI (functional magnetic resonance imaging), FPC (frontoparietal control network), MRI (magnetic resonance imaging), mTBI (mild traumatic brain injury), PTSD (posttraumatic stress disorder), ROI (region of interest)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: April 13, 2016
Footnotes
Supported by the National Institute on Disability, Independent Living, and Rehabilitation Research (grant award no. 90IF0024-01-00) and the National Center for Advancing Translational Sciences (CTSA award no. UL1TR000445).
Disclosures: none.
Identification
Copyright
© 2016 by the American Congress of Rehabilitation Medicine
